Pelvic Health Classfor WomenGet the app
LettersLive Q&ADr. DanaNewsletterGet the app
Kegels

Six weeks is the start

Every trial behind Kegels ran 3 to 6 months. Here is the timeline the research supports, and the daily dose that gets you there.

Board-certified urologist · · 2 min read

"How long until it works?"

It is the first question I would ask too. Here is the answer from the research.

Plan on 12 weeks. Feel changes along the way.

Why 3 months?

The trials that show pelvic floor training works ran 3 to 6 months.[1] So NICE asks for at least 3 months of training as the first treatment for stress or mixed leaks. For prolapse, it asks for at least 16 weeks.[2]

My programs run 6 guided weeks. Week 6 hands you a routine to carry to week 12 and past it.

The daily dose

  • At least 8 contractions, 3 times a day. That is the NICE floor.[2]
  • About 24 a day, for 6 weeks or more. In a meta-analysis, benefits stopped growing past that dose.[3]
  • More training days per week may help. The evidence here is low certainty.[4]
Dr. Dana Kivlin
Class Notes · by Dr. Dana KivlinBoard-certified urologist, Middlesex Health

Get the next letter on Sunday.

1 idea, 1 exercise and 1 reader question from Dr. Dana. Free, in a 3-minute read.

Free. 1 email every Sunday. Unsubscribe in 1 click. Your email stays with us: privacy.

What to expect, stage by stage

  • Weeks 1 and 2, find it. The lift becomes clear. Holds of 2 to 3 seconds.
  • Weeks 3 and 4, hold it. 5-second holds. Add the Knack.
  • Weeks 5 and 6, use it. Sitting, then standing. 8-second holds.
  • Weeks 7 to 12, build it. Holds up to 10 seconds, 3 sets a day. This is the stretch where the trial results live.
  • After week 12, keep it. At least 3 days a week, the lowest dose published for the long run.[5]

The real risk: stopping

In an app trial, 41% of women still trained every day at 3 months.[6]

The method works. The habit fades. So build the habit on purpose:

  1. Anchor it. Same moments every day: coffee, lunch, brushing your teeth.
  2. Shrink it on hard days. 1 set of 8 still counts.
  3. Track it. A tick on a calendar, or a streak in the app.

In the app, one line sits next to your goal: "It's okay to suck, but it's not okay to skip."

12 weeks from today is a date on your calendar. What is the date?

DanaDana Kivlin, DO, board-certified urologist, Middlesex Health

Quick answers

How long do Kegels take to work?

Plan on at least 12 weeks of daily practice. The trials that show pelvic floor training works ran 3 to 6 months, and UK guidelines (NICE) ask for at least 3 months of training as first-line treatment for stress or mixed leaks.

How many Kegels should I do a day?

At least 8 contractions, 3 times a day (NICE). A meta-analysis found benefits stopped growing past about 24 contractions a day, kept up for at least 6 weeks.

Do I have to do Kegels forever?

To keep the results, yes, but less often. After 12 weeks, a routine of at least 3 days a week is the lowest dose published for maintenance.

Written by Dr. Dana Kivlin, DO, board-certified urologist. Updated . Every number links to its source below. This letter teaches; your own doctor diagnoses. How we write

Sources

  1. Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews, 2018. cochranelibrary.com
  2. NICE guideline NG123. Urinary incontinence and pelvic organ prolapse in women: management, 2019. nice.org.uk
  3. Choi H, et al. Meta-analysis of pelvic floor muscle training: randomized controlled trials in incontinent women. Nursing Research, 2007. pubmed.ncbi.nlm.nih.gov
  4. Hay-Smith EJC, et al. Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women. Cochrane Database of Systematic Reviews, 2024. cochranelibrary.com
  5. Woodley SJ, Hay-Smith EJC. Narrative review of pelvic floor muscle training for childbearing women: why, when, what, and how. International Urogynecology Journal, 2021. link.springer.com
  6. Asklund I, et al. Mobile app for treatment of stress urinary incontinence: a randomized controlled trial. Neurourology and Urodynamics, 2017. pubmed.ncbi.nlm.nih.gov
Dr. Dana Kivlin
Class Notes · by Dr. Dana KivlinBoard-certified urologist, Middlesex Health

Liked this? Get the next one Sunday.

Short, sourced and kind. Each Sunday, Dr. Dana sends the one thing she wants every woman to know about her pelvic floor.

  • 1 ideaWhat the research says, in plain words, with its source.
  • 1 exerciseA 2-minute move to try the same day.
  • 1 questionA reader asks. Dr. Dana answers.

Free. 1 email every Sunday. Unsubscribe in 1 click. Your email stays with us: privacy.

Keep reading

More letters from Dr. Dana

All letters
Half of us squeeze wrongKegels · 2 min readTrain before the babyPregnancy and postpartum · 2 min readSqueeze before you sneezeBladder leaks · 2 min read
The app

Turn the letter into a habit.

Pelvic Health Class: for Women: Dr. Dana’s class on your phone. 6-week programs, 1 short lesson a week, 1 guided exercise a day.

  • 5 minutes a dayA guided session with a breathing ring and a timer. The cat lifts with you.
  • 1 lesson a weekWritten by a urologist, in plain words, with every source.
  • Your log stays on your phoneYour answers, notes and photos: only you see them.
Start week 1 free
Coming soonApp StoreComing soonGoogle Play